I awakened just before 5 this morning feeling anxious. As I flipped from one side to the other, my thoughts churned. Though I have plenty of things I could worry about and long lists of things I should get done, I can usually put those thoughts aside and go back to sleep. Not this morning. Why was I feeling unsettled?
Then I remembered one year ago. One year ago, I slept while my father’s nighttime caregiver administered hospice comfort medications at the maximum dosage.
I felt like I had hopped on a freight train that was speeding, careening, barely holding to the rails along a treacherous mountain route that cast dark shadows on our route. I held on, trying to avert disaster.
A week earlier, Dad had been on a plateau, as hospice put it. He was still getting to the table for meals, and we were still making forays for fresh air outside, albeit by wheelchair. I had begun to accept that he would not rally, as I had hoped when came on service with hospice December 20. The nurses had explained that he would likely decline in increments, alternating with periods of stability.
I was Dad’s life ring and he clung to me for security, never wanting me to leave his side. When Todd and I went out to see a movie as a short break, Dad remained at the dinner table with the caregiver, not wanting to retire until I returned. There he stayed, exhausted, counting the minutes until I would return at 9 p.m. I was counting, too. After one brother cancelled his planned trip, I crossed off the days on my calendar until brother Dean would arrive that Wednesday.
Dad’s confusion increased. I sat next to him all day and surrounded him with pictures. At dinner that Monday night, he picked up the picture of my brothers on the kitchen table and said, “They were siblings, weren’t they?”
I broke out in hives. I wondered if it was a reaction to the antibiotic I was taking to resolve a lingering cough, or a physical manifestation of my own anxiety. First my palms itched, then the soles of my feet, then my scalp. As I sat talking to the hospice Chaplain, I furiously scratched my head, twitching from the attempt to stop.
After Dean arrived, Dad’s decline only accelerated. The afternoon of Dean’s arrival, I asked our new afternoon caregiver to make chicken cacciatore. The process turned out to be long and arduous, but the results were delicious. Dad ate heartily, displaying his best appetite in a month. The mood, for that eyelash of time, was celebratory.
But that night, the medications we had pre-dispensed for the hospice nurse weren’t adequate to control Dad’s shortness of breath and agitation. From 11 p.m. on, Dad awakened every half hour. The caregiver summoned Dean during the night to prepare more. At 6:45 a.m. Thursday, Dad attempted to get out of bed by himself, after three weeks of being unable to support his own weight. The caregiver intervened before he fell. Dad was exhausted by the effort.
On Friday, Dean supervised the final move of Dad’s belongings to my house. The afternoon was quiet, with Dad sleeping most of the time. His breathing began to sound increasingly liquid, although the hospice nurse had told us not to be concerned. Just the same, we arranged for a house call the next morning, while I would be out facilitating a strategic planning retreat and Dean would supervise Dad’s care.
When I left that morning, I told Dean to call me with whatever the nurse said. An hour and a half into the retreat, he called with the news to come home. Now. I bluntly announced, “I have to leave. My Dad is dying.” I called my son at school and asked him if he wanted to come home even though Papa might be gone by the time he arrived. He did. My brothers Scott and Bruce booked flights for hours later. As I sat calling family in the living room, I overheard my daughter comforting Dad by reading passages from his favorite poetry. I wrote about preparing. Dad was on his way.
That Friday night turned out to be Dad’s last.
Dean told the story of that evening at Dad’s memorial:
The night before his passing, he was too weak to come to the table for dinner, even in his wheel chair – so Betsy and I brought our dinner into his room. We set up a card table in front of his recliner, squeezed in next to him, and had a quiet time together. In retrospect, he was clearly starting to fade, although Betsy and I did not realize at the time how close he was to the end. He was very sleepy during dinner, and seemed to be in a waking dream state: still connected to the physical world around him, but clearly seeing and responding to other things as well. As we sat together, he looked at me with half-closed eyes and asked, “Dean, will you drive?” This caught me a bit off-guard, but I responded that of course I would. I wish now that I had had the wits to ask him where he wanted to go, but I did not. Afterwards, my first thought was that in his mind he thought we were sitting in our camper on one of our hunting trips, and that he wanted me to drive because he was too tired to carry on. What I’ve now come to believe is something else…. Our hospice nurse told Betsy and me that such restlessness is fairly common, and offered the belief that perhaps those close to death know they have somewhere they need to go, and are so determined to get there they will get up out of bed and walk right out the front door if you aren’t watching over them. Today when I look back on my father’s words, I think he knew it was time for him to leave, and that he wanted me to drive him there. I think he was asking me to take him home.”
Dad is home now. I miss him. But I am glad he is free.